Provider Demographics
NPI:1356571707
Name:KRONENBERG, BILL JEROME (RPH)
Entity type:Individual
Prefix:MR
First Name:BILL
Middle Name:JEROME
Last Name:KRONENBERG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14625 N CAMEO DR
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-2406
Mailing Address - Country:US
Mailing Address - Phone:623-399-8217
Mailing Address - Fax:623-399-8217
Practice Address - Street 1:14625 N CAMEO DR
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-2406
Practice Address - Country:US
Practice Address - Phone:623-399-8217
Practice Address - Fax:623-399-8217
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV06004183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist